Effect of Extending Voluntary Waiting Period on Health of Holstein Friesian Dairy Cows

The aim of this of this experimental study to investigate the effect of 3 voluntary waiting periods (VWP) on health of dairy cows. A total of 100 lactations of 100 Holstein Friesian cows with high milk production (average 9.442 ± 620 kg) were randomly (based on the ear tags digits of cows) distributed to 1 to 3 experimental groups with VWP of 50 (VWPG50;n = 32), 100 (VWPG100;n = 34) or 150 days (VWPG150;n = 34). Observations relating to diseases of the cows were made by the farm veterinarian and research personnel. Were defined eight disease: puerperal fever, retained fetal membranes, displaced abomasum, metritis, clinical ketosis, clinical mastitis, ovarian cysts, and claw diseases. The experimental days (ED) were from 4 days in milk (DIM) to 100 days after the next calving. The experiment was managed at Dairy Research Farm ?imnic-Craiova January 2018 to December 2022. A clear set of clinical signs were used to define a case at the diseases without the need for laboratory confirmation. Values of Lactational incidence risk (LIR) median postpartum days at diagnosis and pairwise comparison of proportion between VWPs were calculated. LIR for puerperal fiver, retained fetal membranes, displaced abomasum, clinical ketosis, clinical mastitis, ovarian cysts and claw disease were 4;5;2;8;8;and 4% respectively. Numerically, cows with VWP of 100 and150 days had more disease cases compared with VWP of 50 days. The differences between experimental groups of cows regarding proportions of cows with disease cases were not statistically significant. Any of the eight disorders reported in this study was analyzed independently to other health problems. For all enrolled cows (n = 100) VWP was extended until 100 or 150 days postpartum with no effect on the lactational incidence risk for the eight disorders analyzed.

Reexamining Positivity of Thinking in Waiting for Godot Through Camus’s Absurdism

Absurdity originated from French existentialism,and Martin Esslin,in categorizing Waiting for Godot as a theater of the absurd,ignores the positive aspects of Camus’s absurdism and regards that as an existential tragedy of mankind.However,the author Samuel Beckett himself did not approve of such a definition,believing that Esslin’s definition of theater of the absurd was too judgmental and pessimistic.Through the imagery of boots,ropes,hats and baggage in Waiting for Godot,Beckett reveals the rootlessness,constraint and agony of the minds of people born into absurdity in the early 20th century.The luck of Lucky is Beckett’s use of irony:people who have lost the ability to think for themselves escape the absurdity and dystopia of life and descend to slaves.Gogo and Didi,who are waiting and expecting,and thinking in the midst of absurdity,represent“Godot”,the symbol of hope.Their endurance in waiting,akin to Camus’s Sisyphus,underscores a form of existential defiance that challenges the notion of absolute pessimism in absurdist literature.

有分离调整和移走时间的两机器no-wait流水作业最大延误问题

以最大延误为目标函数,讨论了两机器no wait流水作业问题解中的工件排列应满足的条件,并根据这些条件给出了几个近似算法.

A Day's Wait会话中的“it”误解的关联解读

关联理论认为人的交际模式应为明示-推理交际。如果交际双方之间存在着认知环境的差异势必会导致交际的失败。本文试图利用关联理论的三个关联观,即语境关联,个体关联和认知关联来解读海明威的短篇小说A Day's Wait会话中的“it”误解,认为小说中父子之间交流的失败和误解是他们关联性不同制造成的,对“it”误解的关联解读,可以更好地理解作者如何通过两个主人公父与子之间会话中“it”误解的巧妙设计,推进故事情节的发展,揭示出作者在刻画他的“准则英雄”形象时对死亡和勇敢的深刻理解,从而显示作者匠心独具的艺术家本色,体现出不凡的艺术成就。

Watch and wait policy in advanced neuroendocrine tumors: What does it mean?

Neuroendocrine neoplasms(NENs) are a group of rare and heterogeneous malignancies, which can develop in various organs. The clinical course of NENs is quite heterogeneous, with different spontaneous growth rates after diagnosis, and different degrees of sensitivity to the same therapy even when they have similar characteristics. Watch and wait(W and W), is a term coined to indicate observation being conducted to assess the evolution of the tumor without administering any anti-tumor therapy. It has been applied to NENs since in extremely rare cases they tend to remain stable for a long time. Although W and W has been reported in several guidelines and recommendations it has never been validated, nor has it been specifically investigated. Furthermore it is not standardized. Therefore its application in clinical practice can differ in terms of tumor status assessment, type and timing of imaging or other exams utilized. In conclusion, while undertaking W and W to delay the first-line therapy by some weeks may be justified in good performance asymptomatic patients with low-grade NENs in order to usefully characterize the disease and patient and thereby choose the best therapy and therapeutic strategy, it seems to be far more difficult to justify W and W with the intent of avoiding an anti-tumor treatment. It should be considered that not only do NENs tend to grow even when they have very favorable biological characteristics but also that the alternative to W and W is most commonly a low toxic and effective treatment with somatostatin analogs.

An Analysis of Language in "Waiting for Godot"

As an important representative of the Theatre of Absurd, in his masterpiece Waiting for Godot, Beckett deserted the traditional dramatic form and adopted a new one that shows us the fragmentary characters and the absurdity of the modern society. This paper demonstrates his artful creation of the language form from the following three aspects: The use of repetition, use of silence and pause and short sentences.

WAIT和WABT在连续重整装置运行中的指导性及其应用

通过浙江石化3.8 Mt/a连续重整装置开车后的运行情况观察,结合相关原理定义解释WAIT和WABT的意义和其在装置运行中所起的指导性作用,并将其反向应用于装置的日常生产,针对当前工况所出现的生产问题及波动给出一种日常优化调整思路。通过工艺优化,确定出合理且相对准确的反应温度从而降低反应所需苛刻度,继而确定当前工况下最优的催化剂活性降低催化剂成本,以及在反应温度、催化剂活性一定的情况下根据进料中硫和氯的含量确定出稳定的注硫量和注氯量从而降低助剂所需成本,最终综合性的调整使装置达到相对经济且稳定的状态下运行,对装置生产优化及能耗方面具备一定指导意义和作用。

Bridging and downstaging treatments for hepatocellular carcinoma in patients on the waiting list for liver transplantation

Several therapeutic procedures have been proposed as bridging treatments for patients with hepatocellular carcinoma(HCC)awaiting liver transplantation(LT).The most used treatments include transarterial chemoembolization and radiofrequency ablation.Surgical resection has also been successfully used as a bridging procedure,and LT should be considered a rescue treatment in patients with previous HCC resection who experience tumor recurrence or post-treatment severe decompensation of liver function.The aims of bridging treatments include decreasing the waiting list dropout rate before transplantation,reducing HCC recurrence after transplantation,and improving post-transplant overall survival.To date,no data from prospective randomized studies are available;however,for HCC patients listed for LT within the Milan criteria,prolonging the waiting time over 6-12 mo is a risk factor for tumor spread.Bridging treatments are useful in containing tumor progression and decreasing dropout.Furthermore,the response to pre-LT treatments may represent a surrogate marker of tumor biological aggressiveness and could therefore be evaluated to prioritize HCC candidates for LT.Lastly,although a definitive conclusion can not be reached,the experiences reported to date suggest a positive impact of these treatments on both tumor recurrence and post-transplant patient survival.Advanced HCC may be downstaged to achieve and maintain the current conventional criteria for inclusion in the waiting list for LT.Recent studies have demonstrated that successfully downstaged patients can achieve a 5-year survival rate comparable to that of patients meeting the conventional criteria without requiring downstaging.

Watch and wait approach in rectal cancer:Current controversies and future directions

According to the main international clinical guidelines,the recommended treatment for locally-advanced rectal cancer is neoadjuvant chemoradiotherapy followed by surgery.However,doubts have been raised about the appropriate definition of clinical complete response(cCR)after neoadjuvant therapy and the role of surgery in patients who achieve a cCR.Surgical resection is associated with significant morbidity and decreased quality of life(QoL),which is especially relevant given the favourable prognosis in this patient subset. Accordingly, therehas been a growing interest in alternative approaches with less morbidity,including the organ-preserving watch and wait strategy, in which surgery isomitted in patients who have achieved a cCR. These patients are managed with aspecific follow-up protocol to ensure adequate cancer control, including the earlyidentification of recurrent disease. However, there are several open questionsabout this strategy, including patient selection, the clinical and radiologicalcriteria to accurately determine cCR, the duration of neoadjuvant treatment, therole of dose intensification (chemotherapy and/or radiotherapy), optimal followupprotocols, and the future perspectives of this approach. In the present review,we summarize the available evidence on the watch and wait strategy in thisclinical scenario, including ongoing clinical trials, QoL in these patients, and thecontroversies surrounding this treatment approach.

Wait公式与Millington经验公式预测地波时延的比较

为了了解用于预测沿光滑分段均匀混合路径传播的地波时延的Millington经验公式的实用性,对Millington经验公式和用于预测沿光滑分段均匀混合路径传播的地波时延的严格的Wait公式进行了比较。在Wait积分法用计算机软件实现的基础上,用上述2种方法分别计算多条实际路径的地波二次相位因子,并对计算结果进行了比较。比较结果表明,在实际工程应用中用Millington经验公式进行地波时延预测符合应用要求。

No-Wait流水车间调度问题的MDIS算法研究

No-Wait流水车间调度问题的特性是工件加工一旦开始,必须连续进行,不允许工件完成某一加工工序后在机器上滞留等待.本文针对目标函数为Makespan的No-Wait流水车间调度问题,从对目标函数结构的分析入手,提出了一种基于最小化工件间距离的初始排序策略和插入方法的启发式算法.通过对大量典型算例的实验后验证了提出的算法的有效性.

Watch and wait approach to rectal cancer: A review

In 2014, there were an estimated 136800 new cases of colorectal cancer, making it the most common gastrointestinal malignancy. It is the second leadingcause of cancer death in both men and women in the United States and over one-third of newly diagnosed patients have stage Ⅲ(node-positive) disease. For stage Ⅱ and Ⅲ colorectal cancer patients, the mainstay of curative therapy is neoadjuvant therapy, followed by radical surgical resection of the rectum. However, the consequences of a proctectomy, either by low anterior resection or abdominoperineal resection, can lead to very extensive comorbidities, such as the need for a permanent colostomy, fecal incontinence, sexual and urinary dysfunction, and even mortality. Recently, trends of complete regression of the rectal cancer after neoadjuvant chemoradiation therapy have been confirmed by clinical and radiographic evaluationthis is known as complete clinical response(cC R). The "watch and wait" approach was first proposed by Dr. Angelita Habr-Gama in Brazil in 2009. Those patients with c CR are followed with close surveillance physical examinations, endoscopy, and imaging. Here, we review management of rectal cancer, the development of the "watch and wait" approach and its outcomes.

Thermal Comfort in Waiting Room at Railway Station in Cold Region in China

A field study and analysis about the thermal comfort was carried out in the waiting room at Beijing West Rail Station in Chinese cold region.Passengers' TSV(thermal sense vote)was obtained using statistical method on the basis of more than 1 200 questionnaires.The linear regression between TSV and indoor temperature indicates that thermal neutral temperature is 25.2 ℃.According to the percentage of satisfaction among all passengers under different indoor temperatures,the acceptable temperature range in the waiting room is 24.2～30.2℃.It is also found that passengers' temporary stay should be taken into consideration for the thermal comfort analysis.Passengers' TSV is not a constant value after they enter the waiting room.In fact,ΔTSV increases as passengers are waiting for the train,and the growing rate is dependent on indoor-outdoor temperature difference.The greater the temperature difference,the faster ΔTSV increases.At last,a linear regression between indoor comfortable temperature and outdoor temperature was generated as the adaptive comfort model.

SOME NEW RESULTS ON WAITING TIME AND BUSY TIME IN M/G/1 QUEUE

This paper considers an M/G/1 queue with Poisson rate lambda > 0 and service time distribution G(t) which is supposed to have finite mean 1/mu. The following questions are first studied: (a) The closed bounds of the probability that waiting time is more than a fixed value; (b)The total busy time of the server, which including the distribution, probability that are more than a fixed value during a given time interval (0, t], and the expected value. Some new and important results are obtained by theories of the classes of life distributions and renewal process.

Using Poisson Modeling and Queuing Theory to Optimize Staffing and Decrease Patient Wait Time in the Emergency Department

Introduction: Studies have shown Emergency Department (ED) crowding contributes to reduced quality of patient care, delays in starting treatments, and increased number of patients leaving without being seen. This analysis shows how to theoretically and optimally align staffing to demand. Methods: The ED value stream was identified and mapped. Patients were stratified into three resource-driven care flow cells based on the severity indices. Time observations were conducted for each of the key care team members and the manual cycle times and service rate were calculated and stratified by severity indices. Using X32 Healthcare’s Online Staffing Optimization (OSO) tool, staffing inefficiencies were identified and an optimal schedule was created for each provider group. Results: Lower Severity Indices (higher acuity patient) led to longer times for providers, nurses, patient care assistants, and clerks. The patient length of stay varied from under one hour to over five hours. The flow of patients varied considerably over the 24 hours’ period but was similar by day of the week. Using flow data, we showed that we needed more nurses, more care team members during peak times of patient flow. Eight hour shifts would allow better flexibility. We showed that the additional salary hours added to the budget would be made up for by increased revenue recognized by decreasing the number of patients who leave without being seen. Conclusion: If implemented, these changes will improve ED flow by using lean tools and principles, ultimately leading to timeliness of care, reduced waits, and improved patient experience.

Non-Invasive Vibration-Stress of the Cirrhotic Liver of Patients Waiting for Transplantation Induces of Circulating CD133+ Stem Lymphocytes Committed Phenotypically toward the Liver

Background: Numerous studies of tissues’ regeneration have confessed the recovery of damaged liver by hematopoietic stem cells. The cells act not only by cell replacement in the target organ but also by delivering trophic factors that support endogenous liver regeneration. A little is known of how organ-derived signals recruit such committed cells into circulation. Objective: We investigated the roles of noninvasive mechanical percutaneous stress of cirrhotic human liver in numbers fluctuation of trophic, liver-specific alpha-fetoprotein-positive fraction of CD133-positive hematopoietic stem cells in lymphocytes of patients waiting for liver transplantation. Methods: To promote in blood the number of the alpha-fetoprotein-positive fraction of CD133-positive hematopoietic stem cells, committed to liver’ tissue, we activated mechanically the cirrhotic liver of patient by transcutaneous micro vibration received from skin-contacted electro-magnetic vibraphones generated mechanical pulses with amplitude 10 μm and smoothly changing frequency from 0.03 kHz to 18 kHz and back forth during one cycle duration 1 minute. The number of the alpha-fetoprotein-positive fraction of CD133-positive hematopoietic stem cells in lymphocytes of potential recipients was controlled by flow cytometry before and during daily sonication of skin area, which corresponds to liver projection on it. The 15 minutes cyclic sonication of the liver area performed daily for three weeks. Results: The sonication increased significantly averaged number of liver-specific alpha-fetoprotein-positive CD133-positive blood lymphocytes in 2 - 3 times compared to a base lane. The second similar sonication, the same zone after three weeks break showed differences with baseline, but it was statistically insignificant. The result was specifically related to the liver as it showed the control sonication of the backbone’s projection on the skin of a separate group of patients with cirrhotic liver from the waiting list. Conclusion: The stem cells committed to the liver recruit from the bone marrow into circulation, when organ mechanically stresses and secretes specific humoral signals to provoke of lymphopoiesis on host liver repair.

Parental acceptability of the watchful waiting approach in pediatric acute otitis media

AIM: To determine parental knowledge about acute otitis media(AOM) and its antibiotic therapy, antibiotic resistance and the willingness to comply with the watchful waiting(WW) approach in primary care settings in southern Israel.METHODS: The study was conducted in 3 primary care clinics and the pediatric emergency room of Soroka University Medical Center. Questionnaires(20 questions on education background, previous AOM experience, knowledge on antimicrobial resistance and attitude vs the WW approach) were filled by 600 parents(150 at each centers) of children < 6 years of age.RESULTS: Mothers represented 69% of parents; 2% had an education of < 10 school years, 46% had high-school education and 17% had an academic degree. 69% parents reported previous experience with AOM and 56% thought that antibiotics represent the only treatment for AOM. Knowledge on bacterial resistance to antibiotics was reported by 57% of the parents; 86% parents were willing to accept/probably accept the WW approach for their children. Logistic regression analysis revealed a significant association between parental education and knowledge about bacterial resistance to antibiotics and that previous experience with AOM was significantly associated with reluctance to accept the WW approach. More parents with knowledge on bacterial resistance were willing to accept the WW approach compared with parents without such knowledge. No correlation was found between the education level and willingness to accept the WW approach. CONCLUSION: A significant correlation was found between previous parental education and experience with AOM and the knowledge about antibiotic use, bacterial resistance and acceptance of the WW approach.

Mean waiting time approximation for a real time polling system

This paper considers a novel polling system with two classes of message which can experience an up-per bounded time before being served. The station serves these two classes with mixed service discipline, one class with exhaustive service discipline, and the other with gated service discipline. Using iterative method, we have developed an approximation method to obtain the mean waiting time for each message class. The performance of approximation has been compared with the simulation results. The expression for the upper bound of waiting time is given too.

Set methods of left-turn waiting zone at signalized intersection

To maximize the number of vehicles passing by the stop-line in a cycle and improve the operation efficiency of intersection in China, the settlement of left-turn lane waiting-zone is becoming prevailing. Based on conflicting-point method, the internal mechanism of left-turn flow after stopping line was analyzed through taking postposition left-turn lane waiting-zone intersection for instance. The relationship between the first left-turn vehicle and the last vehicle of previous phase passing the conflicting point was expounded. According to the time of successive arriving of two vehicle flows at conflicting-point, the reasonable layout for waiting area of left-turn vehicles was researched when the clearance index was less than O. The results suggest that the appropriate layout for waiting area of left-turning vehicles can improve the operation efficiency of intersections.

Waiting Time in Emergency Department in Riyadh 2017

Aim: To investigate the waiting times in the emergency department of both private and public hospitals. Methods: The study employs theoretical, qualitative, and quantitative approaches to come up with conclusions that are reliable. A total of 473 participants who had a direct interaction with the emergency department were asked to provide data on the waiting time, the kind of hospital they went to, the symptoms they had, and their gender for evaluation purposes. Common symptoms identified to the patients visiting the emergency department are related to head and neck, chest, abdominal pains, genitals, limbs, and back. It was found that more patients visited public hospitals over private hospitals. Additionally, more patients had symptoms related to abdominal than any other of the common symptoms and more males than females participated in the research. Data recording is done in tables using MS Excel and data presented through analysis using bar graphs for comparative purposes. Conclusion: Based on the results of the research, it was concluded that the efficiency of the emergency department is below the recommended standards. Finally, the recommendations made from the research findings included an audit of the emergency departments, increasing the staff in the department, and more research should be conducted throughout the country to come up with a more reliable record that is more inclusive.